- Careerbuilder-US (Atlanta, GA)
- …have a VA or compact state RN license . . Must have requirement: Utilization Management experience . Day-to-day: Review cases for medical necessity Summary: . ... Job Title: Utilization Review Nurse I Location: 100% Remote...Works with the Utilization Management team primarily responsible for inpatient medical… more
- University Hospital New Jersey (Newark, NJ)
- …or graduation from a program accredited by the Council on Accreditation of Nurse Anesthesia Education programs prior to January 1998 is required. Certified ... Responsibilities The position of Chief Nurse Anesthetist is responsible and accountable to the...is responsible and accountable to the overall operations and management of the CRNA staff, including hiring, evaluating, and… more
- US Tech Solutions, Inc. (Columbia, SC)
- …. Performs medical reviews using established criteria sets and/or performs utilization management of professional, inpatient or outpatient, facility benefits ... Job Title: Licensed Practical Nurse Location: Columbia, SC 29219 Duration: 06 months...skill sets/qualities: I would love to have someone with prior insurance/ utilization review experience but I know… more
- A-Line Staffing Solutions (Atlanta, GA)
- Job Title: Remote Prior Authorization Licensed Vocational Nurse Pay: $37.17 an hr | Bi-weekly Job Type: Remote Start Date: August 4th, 2024 Shift Options: ... - Sat 8:00 AM - 6:00 PM CST Remote Prior Authorization Licensed Vocational Nurse Overview: This...necessary and will involve computer system data entry, data management , and reporting. Review complex clinical criteria-based prior… more
- Northeast Georgia Health System, Inc (Gainesville, GA)
- …members as needed to ensure services will be covered.Coordinate and communicate with Utilization Review Nurse on a daily, consistent basis to ensure patients ... Job Category:Nursing - Registered Nurse Work Shift/Schedule:8 Hr Morning - AfternoonNortheast Georgia...patient needs; Works collaborate with the Physicians, patient/family, nursing, utilization review and other members of the healthcare team… more
- A-Line Staffing Solutions (Houston, TX)
- …Manager, Case Management , Utilization Review, Utilization Management , LPN, ADN, Clinical Service, Clinical Coordinator, Nurse , Mail Order ... Full time Case Manager Nurse LVN openings in Houston, TX 77027 area...Ensure supportive services are in place to reduce inappropriate utilization patterns and condition exacerbation. Assist members with accessing… more
- A-Line Staffing Solutions (San Antonio, TX)
- …InterQual, ICD-10, Medical Coding, BSN, Medical Management , Utilization Review, Utilization Management , Registered Nurse , MCO, RN, Nurse , Managed ... Full time Case Manager Nurse RN openings in the San Antonio, TX... experience in a managed care setting. Knowledge of utilization management principles and healthcare managed care.… more
- A-Line Staffing Solutions (Dallas, TX)
- …InterQual, ICD-10, Medical Coding, BSN, Medical Management , Utilization Review, Utilization Management , Registered Nurse , MCO, RN, Nurse , Managed ... Case Manager, Case Management , Home Healthcare, Homecare, Home Health, Home Health Nurse , Home Health Case Manager, RN Case Manager, RN Care Manager, CCM,… more
- Northeast Georgia Health System, Inc (Gainesville, GA)
- Job Category:Nursing - Registered Nurse Work Shift/Schedule:12 Hr Morning - EveningNortheast Georgia Health System is rooted in a foundation of improving the health ... Following admission, ensures smooth transition of new patients to primary nurse and other team members. Minimum Job QualificationsLicensure or other certifications:… more
- A-Line Staffing Solutions (Shaker Heights, OH)
- …Case Manager, Medical Coding, BSN, Medical Management , Utilization Review, Utilization Management , Waiver Program, Registered Nurse , MCO, RN, ... Case Manager, Medical Coding, BSN, Medical Management , Utilization Review, Utilization Management , Registered Nurse , MCO, RN, Nurse , Managed… more
- A-Line Staffing Solutions (Mcallen, TX)
- …Monday through Friday, 40 hours per week Competitive Pay Rate! Keywords: RN, Registered Nurse , BSN, MSN, ADN, Case Manager, Utilization Manager, UR, UM, ... Utilization Review, Case Management , Medicare, Medicaid, CMS, URAC, Rx, CCM, Home Health,...Customer Service, Healthcare, Inbound Calls, Outbound Calls, RN, Registered Nurse , BSN, MSN, ADN, Case Manager, Utilization … more
- Almost Family (Fond Du Lac, WI)
- …MO, NC, NY, OH, PA, TN, VA: No additional requirements. Skill Requirements Prior management experience preferred. Knowledge of home care regulations and ... for home care services and establishment of frequencies and utilization for new admissions. Works closely with the Agency...staff as directed. License Requirements Must be a Registered Nurse licensed in the state of practice. Minimum of… more
- A-Line Staffing Solutions (San Antonio, TX)
- …Keywords: Care Coordinator, Care Coordination, Discharge Planning, Admission Planning, CMS, Utilization Review, Utilization Management , Home Health, Home ... Manager, Case Management , Care Manager, Care Management , Medical Management , Community Health, Referrals, LVN, Licensed Vocational Nurse , Clinical Care,… more
- A-Line Staffing Solutions (Tampa, FL)
- …Case Manager, Medical Coding, BSN, Medical Management , Utilization Review, Utilization Management , Registered Nurse , MCO, RN, HMO, Concurrent Review, ... Public Admin, Social Science, Social Work, Sociology) 2+ years of Care Management experience Experience with electronic medical health records, and Microsoft office… more
- A-Line Staffing Solutions (Haverhill, FL)
- …Case Manager, Medical Coding, BSN, Medical Management , Utilization Review, Utilization Management , Registered Nurse , MCO, RN, HMO, Concurrent Review, ... Public Admin, Social Science, Social Work, Sociology) 2+ years of Care Management experience Experience with electronic medical health records, and Microsoft office… more
- Brighton Health Plan Solutions, LLC (Chapel Hill, NC)
- … Utilization Management services to its clients. The Utilization Management Nurse - Prior Authorization performs medical necessity reviews on ... any time with or without notice. Primary Responsibilities * Perform prospective utilization reviews and first level determinations for members using evidenced based… more
- CVS Health (Lansing, MI)
- …8a-5pm Est time.) No travel is required.Applicants from any state can apply. Prior Authorization UM Nurse Consultant Utilizes clinical experience and skills in ... internal and external constituents in the coordination and administration of the utilization /benefit management function. For more information on our benefit… more
- Cleveland Clinic (Stuart, FL)
- …three years equivalent full-time clinical experience as a Registered Nurse . + Prior Utilization Management experience is preferred. + Knowledge of ... caregivers in a family-oriented, supportive environment. As a PRN Utilization Management (UM) Specialist, you will perform...future caregiver is someone who: + Is a Registered Nurse (RN) with at least three years of clinical… more
- CVS Health (Austin, TX)
- …to work in a fast paced environment Preferred Qualifications + Previous prior authorization experience Education Associates degree required BSN preferred Pay Range ... The typical pay range for this role is: $29.10 - $62.31 This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of… more
- AdventHealth (Tampa, FL)
- …avoidance strategies including concurrent payer communications to resolve status disputes. The Utilization Management Nurse is accountable for a designated ... **The rol** **e you'll contribute:** The role of the Utilization Management (UM) Registered Nurse ...processes as required, ensuring proper authorization has been secured prior to or at the time of discharge for… more
